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Brazilian Oral Research, Volume: 26, Número: spe1, Publicado: 2012
  • Contributions to the debate on integrality and oral health Editorial

    Tomita, Nilce Emy; Rode, Sigmar de Mello
  • Genetics and caries: prospects Symposium Proceedings - 16th Congress Of The Aboprev

    Vieira, Alexandre Rezende

    Resumo em Inglês:

    Caries remains the most prevalent non-contagious infectious disease in humans. It is clear that the current approaches to decrease the prevalence of caries in human populations, including water fluoridation and school-based programs, are not enough to protect everyone. The scientific community has suggested the need for innovative work in a number of areas in cariology, encompassing disease etiology, epidemiology, definition, prevention, and treatment. We have pioneered the work on genetic studies to identify genes and genetic markers of diagnostic, prognostic, and therapeutic value. This paper summarizes a presentation that elaborated on these initial findings.
  • Case Report Form for oral health assessments: methodological considerations Symposium Proceedings - 16th Congress Of The Aboprev

    Carvalho, Joana Christina

    Resumo em Inglês:

    Information on the oral health condition of the target population is required to enable the development of policy strategies for oral health promotion. This information needs to be substantiated by reliable data obtained through regular oral health assessments. Countries around the world have set up oral health data-registration systems that monitor the oral health of the population. These systems are either integrated in the public oral health care service or in national surveys conducted on a regular basis. This paper describes the conception and development of a Case Report Form for oral health assessments and introduces a recently developed electronic data-registration system for data capture in oral health surveys. The conception and development of a Case Report Form poses a number of challenges to be overcome. In addition to ensuring the scientific quality of its contents, several requirements need to be met. In the framework of national oral health surveys, handwritten data capture has proven accurate, but entails an important workload related to the printing and transporting of the forms, data transfer and storage of the forms, as well as the time required to perform these tasks. On the other hand, electronic data capture enables time saving and better performance. However, the advantages of this system may not be fully acknowledged by general practitioners, and their motivation to employ information and communication technologies may need to be encouraged. In the long term, the inclusion of electronic data registration in university training is probably the best strategy to achieve this.
  • Social disparity and oral health Symposium Proceedings - 16th Congress Of The Aboprev

    Navarro, Maria Fidela de Lima; Modena, Karin Cristina da Silva; Bresciani, Eduardo

    Resumo em Inglês:

    There is a clear reported association between social disparity and oral health, for example, between dental caries and malnutrition in children. This fact is detected in several studies, and also found amongst the Brazilian population. However, several efforts have been made to improve the quality of life of the population and to achieve the 2015 Millennium Development Goals. Oral health is a branch to be improved among these goals. The Brazilian experience has been drawing the attention of authorities, insofar as there have been direct improvements in oral health through state oral health programs, and also indirect results by improving the quality of life of the population. Included within the Brazilian oral health programs are the Family Health Program and Smiling Brazil Program. The former is a global healthcare program which involves primary oral healthcare, while the latter is a specialized oral care program. Among the social programs that would indirectly improve oral health are Family Stipend and the Edmond and Lily Safra International Institute of Neuroscience of Natal (ELS-IINN). In conclusion, although oral health problems are related to socioeconomic factors, the implementation of primary oral health programs and programs to improve the population's quality of life may directly or indirectly improve the oral health scenario. This fact is being observed in Brazil, where the oral health policies have changed, and social programs have been implemented.
  • Smoking and periodontal tissues: a review Symposium Proceedings - 16th Congress Of The Aboprev

    César Neto, João Batista; Rosa, Ecinele Francisca; Pannuti, Cláudio Mendes; Romito, Giuseppe Alexandre

    Resumo em Inglês:

    The impact of smoking on general health has been widely studied and is directly related to several important medical problems including cancer, low birth weight, and pulmonary and cardiovascular disease. In the past 25 years, there has also been an increasing awareness of the role of cigarette consumption in oral health problems such as periodontal disease. Smoking is considered the major risk factor in the prevalence, extent and severity of periodontal diseases. This article will discuss the available evidence and provide the reader with an overview of the impact of smoking and its cessation on the pathogenesis and treatment of periodontal diseases.
  • Periodontal disease: a genetic perspective Symposium Proceedings - 16th Congress Of The Aboprev

    Taba Jr, Mario; Souza, Sergio Luis Scombatti de; Mariguela, Viviane Casagrande

    Resumo em Inglês:

    Periodontitis is a multifactorial disease that causes tooth loss. The complex pathogenesis of periodontitis implies the involvement of a susceptible host and a bacterial challenge. Many studies have provided a valuable contribution to understanding the genetic basis of periodontal disease, but the specific candidate genes of susceptibility are still unknown. In fact, genome-wide studies and screening of single-nucleotide polymorphisms have yielded new genetic information without a definitive solution for the management of periodontal disease. In this manuscript, we provide an overview of the most relevant literature, presenting the main concepts and insights of the strategies that have been emerging to better diagnose and treat periodontal disease based on biomarker analysis and host modulation.
  • Periodontal disease and systemic complications Symposium Proceedings - 16th Congress Of The Aboprev

    Oppermann, Rui Vicente; Weidlich, Patricia; Musskopf, Marta Liliana

    Resumo em Inglês:

    Periodontal diseases comprise a number of infectious and inflammatory conditions brought about by the interaction between supragingival and subgingival biofilms and the host inflammatory response. Periodontal diseases should be considered systemic conditions. This means that they are both modulated by the body's systems and play a role as a risk factor for systemic derangements. The current evidence supports some of these interactions, such as smoking as a risk factor for periodontal disease and diabetes mellitus, as both influenced by and influencing inflammatory changes in the periodontal tissue. Other potential associations are still being researched, such as obesity, hormonal changes, cardiovascular disease, and adverse outcomes in pregnancy. These, and others, still require further investigation before the repercussions of periodontal disease can be fully elucidated. Nevertheless, at the present time, the treatment of periodontal diseases-and, most importantly, their prevention-enables adequate intervention as a means of ensuring periodontal health.
  • Oral health promotion: expanding the boundaries of knowledge Symposium Proceedings - 16th Congress Of The Aboprev

    Paula, Lilian Marly de; Melo, Nilce Santos de; Mestrinho, Heliana Dantas
  • Pain and disease according to integral anthroposophical dentistry Symposium Proceedings - 17th Congress Of The Aboprev

    Galitesi, Célia Regina Lulo; Andrade, Flaviana Bombarda de; Borges, Ana Flávia Sanches

    Resumo em Inglês:

    From an academic standpoint, the university format, in general, has been nurturing a "paradigm of expertise" and, consequently, the relationship between specialties has declined. The upshot is that recent college dental graduates have adopted a clinical performance focusing on system parts and their specificities, in detriment to a more comprehensive view of the mouth and of the patient as a whole, with his/her vital, emotional and individual attributes. An interaction between the several different areas of human knowledge is needed imminently to decrease the dichotomy in professional behavior, because the demand for professionals and dental patients interested in a more comprehensive approach are increasing day by day. Patients want to know: "What, in fact, is behind the etiological extrinsic and intrinsic factors that maintain neuropathic pain, recurrent thrush, or persistent halitosis," among other questions, "even under the care of a dentist?" or "Why is this disease affecting me?" There are several issues composing the paradigm of salutogenesis: What are the essential aspects that constitute a healthy individual, overlapping the usual investigation: How to destroy, avoid and quell the pathological agents? A proposed approach is based on salutogenesis, which examines such issues. According to this approach, anthroposophical dentistry includes determinant factors, determinants of health, basic research and the development of oral health promotion, thus connecting dental academia with integrative thinking, while also complementing and gathering information that subsidizes basic research with the primordial concepts on laws governing the parameters involved in the vital processes of nature.
  • Are we ready for caries prevention through bacteriotherapy? Symposium Proceedings - 17th Congress Of The Aboprev

    Twetman, Svante

    Resumo em Inglês:

    Recent insights in medical science indicate that human biofilms play an important role in health and well-being, and have put microbiota modulation through bacteriotherapy into focus. In dentistry, bacterial interference with probiotic bacteria to support the stability and diversity of oral biofilms has gained similar interest. Investigations in vitro into metabolic activity, co-aggregation, growth inhibition, bacteriocin production, and adhesion have collectively suggested a potential role for probiotic lactobacilli and bifidobacteria to modulate the oral microbial ecology. Likewise, short-term clinical studies with intermediate microbial endpoints indicate that interference with caries-associated bacteria seems possible through probiotic dairy products, tablets, lozenges and chewing gum in various dose regimens. Few randomized controlled clinical trials with caries outcomes are available, but three studies with preschool children and the elderly have demonstrated preventive fractions between 21% and 75%, following regular intake of milk supplemented with probiotic lactobacilli. However, further large-scale trials with orally derived anti-caries candidates are needed before we can say that we are ready for bacteriotherapy as an adjunct to complement the existing evidence-based methods for preventing and controlling caries in daily practice.
  • Oral health in Brazil: the challenges for dental health care models Symposium Proceedings - 17th Congress Of The Aboprev

    Chaves, Sônia Cristina Lima

    Resumo em Inglês:

    This paper discusses adult oral health in Brazil according to three perspectives: 1) the available epidemiological evidence about the population's oral-health-related epidemiological situation, especially adults and the elderly population, in relation to two high prevalence oral injuries (dental caries and tooth loss), 2) the main health care models for dealing with this situation, by analyzing the related historical processes in order to reveal the likely social, political and epidemiological implications of the different models, and 3) lastly, the possible challenges to Brazilian dentistry or collective oral health in overcoming these obstacles. The main results of the study indicate that, from an epidemiological point of view, Brazil is undergoing a transition in dental caries and tooth loss, which is not yet reflected in the profile of the elderly, but which is tentatively evidenced in young adults. Tooth loss remains high. Certain aspects of society's economic and political superstructure have an important impact on oral health indicators and existing inequalities. Oral health care models have a relative importance and must not be neglected. Vestiges of ideological movements, like preventive medicine, may explain the current impasse in collective oral health practices, such as the preeminence of Finalized Treatment (FT) in clinics and of preventive care in schools fostered by community-based programs. It is therefore important to develop conceptual, theoretical reflections and to increase the objects of intervention, their purposes and their modus operandi. The practice of dentistry according to these alternative models is still being constructed. New studies related to the different formats of these new practices are recommended.
  • Programmatic actions in oral health: coping with social inequities Symposium Proceedings - 17th Congress Of The Aboprev

    Ferreira, Efigênia Ferreira e; Tomita, Nilce Emy; Dalben, Gisele da Silva

    Resumo em Inglês:

    Inequities are health imbalances that are avoidable, unfair and unnecessary. Studies on health inequities address the need for emergency care related to oral-dental lesions from external causes, toothache or prevalence of oral lesions, taking into account the differences between individuals and/or populations in terms of risk conditions to acquiring disease or access to health services. Inequities may be caused by the health service itself, because diseases affect socially deprived individuals more frequently and severely, especially because of multimorbidity. In the current Brazilian public health situation, programmatic actions are based on technological knowledge, especially epidemiology, focused on specific pathologies or disease risk groups, and relate closely to the organization of programmed demand. Moreover, programmatic actions should strategically use technological devices, without disregarding technical and policy flexibility, and should be closely related to inter-subjectivity and ethics, in order to develop emancipating capabilities. An action having this structure could make it easier to achieve Universality, Equity and Integrality.
  • Inequalities in oral health and oral health promotion Symposium Proceedings - 17th Congress Of The Aboprev

    Moysés, Samuel Jorge

    Resumo em Inglês:

    This article offers a critical review of the problem of inequalities in oral health and discusses strategies for disease prevention and oral health promotion. It shows that oral health is not merely a result of individual biological, psychological, and behavioral factors; rather, it is the sum of collective social conditions created when people interact with the social environment. Oral health status is directly related to socioeconomic position across the socioeconomic gradient in almost all populations. The main priority for dental interventions is that they be integrated collaboratively and enable research and policies that address the main proximal determinants of oral diseases, i.e., sugars, smoking, hygiene, and risk behaviors. Adopting a mixed approach, these interventions should also reduce inequality, focusing on the socioeconomic determinants, to change the slope of the social gradient. The cornerstone of this approach is the Integrated Common Risk Factor Approach (CRFA).
  • Constructing public oral health policies in Brazil: issues for reflection Symposium Proceedings - 17th Congress Of The Aboprev

    Soares, Catharina Leite Matos

    Resumo em Inglês:

    This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from both Market Dentistry and Preventive and Social Dentistry in Brazil. Among the state activities that have been set into motion, the following stand out: the drafting of a law to regulate the fluoridation of the public water supply, and the fluoridation of commercial toothpaste in Brazil; epidemiological surveys to analyze the status of the Brazilian population's oral health; the inclusion of oral health in the Family Health Strategy (Estratégia de Saúde da Família - ESF); the drawing up of the National Oral Health Policy, Smiling Brazil (Brasil Sorridente). From the literature consulted, the progressive expansion of state intervention in oral health policies is observed. However, there remains a preponderance of hegemonic "dental" practices reproduced in the Unified Public Health Service (Sistema Único de Saúde - SUS) and the Family Health Strategy.
  • Impact of dental caries on preschool children's quality of life: an update Symposium Proceedings - 17th Congress Of The Aboprev

    Bönecker, Marcelo; Abanto, Jenny; Tello, Gustavo; Oliveira, Luciana Butini

    Resumo em Inglês:

    The literature reports that dental caries can cause functional, physical and aesthetic impairment, often with repercussions on children's general health at an early age. Moreover, recent studies have investigated how caries lesions can compromise children's quality of life. This paper aims to describe the current situation of dental caries prevalence in children and how this oral health disease can impact their quality of life.
  • Epidemiology of dental caries: when structure and context matter Symposium Proceedings - 17th Congress Of The Aboprev

    Frazão, Paulo

    Resumo em Inglês:

    The widespread expansion of the sugar market drove dental caries prevalence to high levels in several regions of the world. On the other hand, the dissemination of fluoride use is one of the reasons for caries decline at the end of the 20th century. However, caries remains one of the most prevalent non-communicable chronic diseases in human beings, and an important cause of pain and dental loss, which lead to school and work absenteeism affecting individuals' daily activities and emotional stability. The decline in caries has important implications for research, human resources and oral healthcare. The aim of this study was to summarize the changes in dental caries occurrence in the population, and bring to light the latest research on the role of non-biological determinants in caries distribution.
  • Mechanisms and clinical management of pain Symposium Proceedings - 17th Congress Of The Aboprev

    Stump, Patrick Raymond Nicolas Andre Ghislain; Dalben, Gisele da Silva

    Resumo em Inglês:

    Pain is an unpleasant, sensitive and emotional experience associated with or described in terms of tissue lesion, and may be acute or chronic. It may also be classified as nociceptive, neuropathic or psychogenic. Nociceptive pain involves the transformation of environmental stimuli into action potentials carried to the central nervous system, where they are modulated and integrated up to final interpretation in the cerebral cortex. Neuropathic pain may arise as a consequence of the direct lesion of axons, or of an increase in the production of neurotrophic factors. Chronic pain is always associated with anxiety and some degree of depression. Drug therapy should be selected according to its efficacy; nonetheless, the professional should also consider the tolerability and adverse effects that may occur, for example, in elderly individuals. It is necessary to emphasize the safety-considering the possibility of drug interactions-and define the posology to promote better adherence. However, the treatment of neuropathic pain should not be limited to the use of analgesic drugs, which are just one among several options enabling patients to participate in bio-psycho-social rehabilitation programs.
  • Orofacial pain and temporomandibular disorders: the impact on oral health and quality of life Symposium Proceedings - 17th Congress Of The Aboprev

    Conti, Paulo César Rodrigues; Pinto-Fiamengui, Lívia Maria Sales; Cunha, Carolina Ortigosa; Conti, Ana Cláudia de Castro Ferreira

    Resumo em Inglês:

    Many conditions may cause painful symptoms in orofacial structures. Among the chronic conditions that affect this area, temporomandibular disorders are the most common. Temporomandibular Disorder is a collective term that includes a number of clinical complaints involving the masticatory muscles, the Temporomandibular Joint and associated structures. In some cases, these complaints can be associated with depression, catastrophizing behavior and impact on quality of life. The present study aims to explain the relationship between Temporomandibular Disorders and pain chronification and their relation to a variety of psychosocial and behavioral comorbid conditions. The mechanisms of pain conduction and suggestions for management are also addressed.
  • Oral health under an integrality perspective Symposium Proceedings - 17th Congress Of The Aboprev

    Tomita, Nilce Emy; Marta, Sara Nader; Dalben, Gisele da Silva
  • Daily biofilm control and oral health: consensus on the epidemiological challenge - Latin American Advisory Panel Symposium Proceedings - 17th Congress Of The Aboprev

    Rode, Sigmar de Mello; Gimenez, Xiomara; Montoya, Victoria Criado; Gómez, Mariel; Blanc, Silvia Lopez de; Medina, Marco; Salinas, Elmer; Pedroza, Janeth; Zaldivar-Chiapa, Rosi Maria; Pannuti, Claudio Mendes; Cortelli, José Roberto; Oppermann, Rui Vicente

    Resumo em Inglês:

    Our understanding of dental plaque biofilm has evolved since the nonspecific plaque hypothesis that considered plaque as a nonspecific mass of native microorganisms that, because of lack of oral hygiene, builds up in proportions great enough to overcome the host resistance threshold and affect the tooth structure and tooth supporting tissues. A great diversity of microorganisms-over 700 species-was detected in the oral cavity, and evidence shows that the investigation of specific microorganisms or associations of microorganisms as etiological agents for periodontal diseases and caries is not a simplistic approach. Although clinical evidence shows that oral mechanical hygiene is fundamental to prevent and control caries and periodontal disease, it is important to highlight that optimal control is not achieved by most individuals. Thus the complementary use of chemotherapeutic agents has been investigated as a way to overcome the deficiencies of mechanical oral hygiene habits, insofar as they reduce both plaque formation and gingival inflammation, and represent a valid strategy to change the biofilm and maintain dental and periodontal health. The role of the dental professional is to monitor patients and offer them the best recommendations to preserve oral health throughout their life. With this in mind, chemical control should be indicated as part of daily oral hygiene, together with mechanical procedures, for all individuals who present supragingival and/or subgingival biofilm, taking into account age, physical and/or psychological limitations, allergies, and other factors.
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